Hepatitis C Infection(HCV, Hep C)

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

Generally, people with chronic infection with hepatitis C develop no symptoms
until they have extensive scarring of the liver (cirrhosis). Some individuals,
however, may have
fatigue and other non-specific symptoms in the absence of
cirrhosis. A minority of patients with hepatitis C have symptoms from organs outside of
the liver.

In the U.S., infection with hepatitis C is the most common cause of chronic
hepatitis and the most common reason for liver transplantation.

Hepatitis C is diagnosed by determining levels in the blood of
antibodies to the virus and then confirming the infection with other tests for viral RNA. The amount of viral RNA
in the blood (viral load) does not correlate with the severity of the disease
but can be used to track the response to treatment.

A
liver biopsy may be used to assess the amount of liver damage (liver cell
injury and scarring), which can be important in planning treatment. Other tests
that carry less risk than liver biopsy can be used to evaluate for scarring
in some patients.

Considerable progress has been made in the treatment of hepatitis C. The
rate of cure has increased (above 90%-95%) with the development of direct acting all-oral drug regimens.

Treatment results in reduced inflammation and scarring of the liver in most
patients who are cured of hepatitis C and also occasionally (and to a much lesser extent) in
those who relapse or are not cured.